MEDICARE: DR. STEVEN D FITZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18090	OH

General Provider Information

NPI Number	:	1336249408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN D FITZ

Provider Business Mailing Address
First Line	:	4827 STATE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5542
Country	:	US
Telephone Number	:	216-741-1067
Fax Number	:	216-741-6591

Provider Business Practice Location Address
First Line	:	4827 STATE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5542
Country	:	US
Telephone Number	:	216-741-1067
Fax Number	:	216-741-6591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/08/2013

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